Medical School Guide

Hello Touroites, or Tourettes, or whatever. If you’ve found this page then you are most likely an incoming first year medical student or masters student and are looking for relevant books/resources to make the next few years much easier (and save some money). Well, good news! That’s what this little page is all about. This year I’ve added a table of contents so you can just skip to the good stuff.

Hi. My name is Mike, and I am a departing 4th year medical student at Touro-Harlem. I’ve been trying to help first and second years be successful ever since I was in your shoes. Over the last four years I’ve been able to help answer many questions about the program and how to maximize your ability to succeed. Now I want to make it available for you here.

If you are really curious, you can read more about me throughout this blog, but the bottom line (and why you should listen to me) is that I was a successful student at Touro. I was able to keep my grades and board scores high, volunteer actively, and participate in many outside activities by tweaking my study habits and resources to fit our curriculum. I was an Anatomy, Physiology, and Biochemistry tutor at Touro, and still help students with these subjects.

Every year, many students make the same mistakes of focusing on the wrong materials, using too many resources, or (very rarely) too few. Learn from those who have made these mistakes and focus only on what you need to succeed.

Like all of those classes in undergrad, Touro will send you a list of required and recommended sources a mile long. Most of these items will never (or very rarely) be used. You will also hear about tons of outside study aids such as Pathoma, SketchyMicro/Pharm, Firecracker any many, many more. Don’t do what I did and spend unnecessary money and time trying out everything.

Here I will be listing the most useful resources for each class, and will even occasionally point out the least useful so that you can steer clear of them. My recommendations will be based on my experiences, alongside the reviews and suggestions of many current third and fourth year students.

Before Medical School/Life in New York

If you are like me and moved across the country to NYC, then you are in for a big culture shock. Life in the Big Apple is very different than almost anywhere else in the country. Most of you will likely live in Manhattan, and will not have a vehicle. This made buying simple things like headphones or kitchen items much more difficult and time consuming.

After trying to take 50 pounds of household items on the subway, I gave up buying almost everything in person. It was too time consuming and very inefficient. Since then, I have purchased almost everything through Amazon Prime. You get free 2-day shipping on almost anything, and most of the prices are better than going to Target or Ikea. The best part is that you never have to leave your apartment.

Since you’re about to be a medical student, you can use your Touro email to sign up for Amazon Prime-Student and get the first 6-months for free. Even if you cancel it immediately after you buy your textbooks, the free (and super fast) shipping makes this extremely worthwhile. Seriously this is best thing ever.

If you want to sign up, here is the link to get to the Amazon Prime-Student page.

http://a.co/5kROqIA

VLC (Speed up!)

Some of you who have friends already in medical school may have seen us refer to watching lectures or videos at 1.5x, 2x, or even 3x speed. When I first started at Touro I had no idea how anyone did this. It took a week or two before I realized I could save a ton of time by speeding up lectures and that I could still retain the material. Now, after 4 years I pretty much never listen to any type of educational video sped up less than 2-times its normal speed.

There are dozens of options for video playback software that offer the ability to speed up your videos. One of the more popular programs is that VLC Media Player. It is 100% free to use, and compatible with almost any platform including Windows, Mac, and even Linux if you’re into that kind of thing. Additionally, it is super easy to use: the “+” and “-” buttons on your numpad will speed up and slow down your video.

If you’re not used to watching sped up videos, start slow. Speed up an anatomy lecture to 1.5x speed and see how it goes. Some lecturers can be sped up significantly, while I had to watch others at only 1.5x normal speed. You’ll get used to it.

Youtube speed up plugin – MYstream?

Anatomy Lecture

REQUIRED: Netter’s Atlas of Human Anatomy (DO NOT BUY)

Optional: Gray’s Anatomy Review (MAY NOT NEED TO BUY)

BRS Anatomy

You can pass the Anatomy lecture course with just the powerpoint slides and a Netter’s Atlas. Watch the videos, take notes, and review structures every night and you’ll pass. This class makes up the majority of the units you are taking this semester, so you should dedicate the majority of your time to it.

If Dr. Rich is still the professor, anything she says during the review sessions is pure gold. She will literally read off the test and give you the questions or significant topics that will be on the exam. These are free points, and are usually high yield for the boards (although anatomy is relatively low yield as far as Step I goes). Do not miss these sessions, or at least get the notes from someone else.

The Gray’s Anatomy Review has really tough, but really good questions. I found that if I was approaching 75-85% on the end of chapter questions that I was in good shape for the exam. Someone put a PDF of a poorly photocopied version of this book into our class’ dropbox, so you may have it. I would try very hard to find a digital copy of this book as the only useful part (for me) is the questions.

BRS anatomy is a bullet-point list of relevant anatomy points, with easy questions at the end of the chapter. I bought this book as an easy reference for studying, and used it for the tables and condensed information for insertions/origins of muscles. It was also fairly useful as a list of all the annoying functions of the cranial nerve nuclei and which CNs carry Motor/sensory/autonomic activity (don’t worry if that sounds like gibberish, you’ll get there). This was definitely not necessary, but I found it somewhat helpful. Our study group shared this one copy and didn’t have any problems.

Anatomy Lab

REQUIRED: NONE

Optional: Shared Netter’s Atlas for your table

Grant’s Dissector

Anatomy lab can easily make or break your grade if you’re going for the A. They are very good at picking out that one structure you don’t know, or positioning the body in a way that throws you off. The only secret to this class is spending extra time in the lab. I went from getting decent Z scores to getting above 2 on every practical by spending a few extra hours with the cadavers every week (with even more hours right before the exam) with my study group. It’s not the most fun way to spend your time, but it was worth it. Make sure to look at every cadaver! Yours will only be tagged for one or two structures, so it’s necessary to look at everyone else’s too.

One member of my lab group was able to print out the dissection instructions before every session. I don’t remember looking at Grant’s more than once or twice the entire year. If you are forced to buy it, split it between your lab group so you only spend a few dollars on it.

However, by the end of the year, pretty much every group did have an extra Netter’s atlas at their table. You won’t want to take this book back out of the lab after touching it with cadaver hands, so buy a used copy or an old edition if you can find it. Again, splitting it amongst your group makes this book only a few dollars and well worth it. The cadaver structures can be very difficult to identify or cement in your mind, so having a perfectly illustrated picture is clutch. Write your lab table or name on the side with sharpie before you put it in there or it can “mysteriously vanish” to other tables.

Biochemistry/Genetics

REQUIRED: NONE

Optional: Lippincotts Illustrated Biochemistry (Almost required)

BRS Biochemistry

If you do not have a biochemistry background/have never taken biochemistry, then this will be a tough class for you. I was lucky enough to have taken several BioChem courses before medical school, and had an above average grasp of the material. Full disclosure: I’m one of the very few who love BioChem. I may oversell it here even though it’s not the biggest section on the board exams.

For the boards, 90% of the BioChem questions are on the details that are relevant to human disease. They will not ask you what the isoelectric point of Guanine is, but they might ask you what part of the electron transport chain Cyanide interrupts (it’s the fourth: Cytochrome C oxidase if you’re curious). This information becomes quasi useless after Step I, but you need to know it now. Just focus on the stuff that you can pinpoint to human disease if you can. Hopefully the professors will tell you what that is.

That being said, I think you could pass BioChem at Touro with just the powerpoint slides. If Dr. Binstock is still the professor, her slides covered all the exam material. Knowing them front and back would be enough to do well in the course. You may not have a thorough grasp of all the board relevant concepts, but you can be passable.

One of the few textbooks that I read almost cover-to-cover was the Lippincott Illustrated Biochemistry book. It was short (for a textbook anyway) and covered everything. I even got a question correct on my boards about lab procedures that I only read in this textbook. When students are struggling with BioChem, I usually start by bringing out my textbook and go over the relevant section with them. They may have updated the curriculum to include it now, but I don’t regret purchasing the book. Again, sometimes there is a digital copy floating around, so you could probably avoid buying it.

As always, the BRS book offers a short bullet point list of things they feel you should know, with some easier questions at the end of the chapter. Some of my class used this book, but I did not like how they organized the material nor the questions. The one upside is that it will be somewhat faster to go through that book than the Lippincott. If you’re pressed for time (although who isn’t, right?) it would be the faster option.

Final disclosure: Very few people that I know read or bought the Lippincott book. All I know is that I did and do not regret it at all.

Biostats/Behavioral Science/Epidemiology/Public Health etc

REQUIRED: NONE (Covered in First Aid)

Optional: BRS Biostatistics

Kaplan Behavioral Science

I felt this was poorly taught at Touro. This may have changed, but Dr. Sonpal taught BioStats to us, and flaked on a few lectures or glossed through some of the concepts. Dr. Gardere did a good job with the other aspects, but it was eerily similar to the Kaplan course (i.e. that’s what they followed). Luckily the UWORLD question bank does a good job teaching this subject, and BioStats is one of the few subjects you can cram pretty quickly. Don’t try either one of these until second year though. It’s just not worth it.

Dr. Gardere and Dr. Sonpal basically followed the Kaplan Behavioral Science curriculum, so try to find the PDF of that textbook floating around. We had a copy and it really helped solidify the concepts pretty well. The BRS Biostatistics covers some material that we did not get at Touro and has some decent extra practice questions if you finish UWORLD and still need some. I don’t feel like any of the extra stuff was on my board exams, but you never know.

Embryology

REQUIRED: NONE?

Optional: BRS Anatomy (has some sections on Embryo)

Youtube videos/tutorials

This was another terribly taught class at Touro. There were random Embryo lectures scattered into our Anatomy courses, and the entire sequence was out of order. If I remember correctly, we had a few lectures on weeks 10-20 before we went back and did 1-4 and so on. Anyways, it was terrible and I usually just crammed right before the exam or accepted the fact that I would get most of those 5-10 questions wrong.

The good news, however, is that Embryology is very low yield for boards and I can’t recall a single question about it on my Step 1 exam. You should still review it though because they can potentially ask basic questions about it. Again, I’d focus on the aspects that affect human disease, such as the common birth defects and how they occur.

Our lecture notes were essentially useless, but that may have changed by now. The BRS Anatomy book had a little bit of information on embryology, but was overall not very good. I would definitely NOT recommend buying a book exclusively for embryo. Instead, watch a few videos on youtube and try to coordinate that information with your lecture notes.

Junqueira’s is another one of the top 3-4 textbooks I think you must purchase for medical school. I read every page in this book at least once, and it is very good at helping you master the basics. Histology was one of the hardest classes for me, and I remember dreading every exam and lab day. The digital microscopes through your laptop is annoying, and I didn’t feel like I learned much during those sessions. I usually had Junquera out and compared what a perfect structure looked like to our slides.

One of my roommates had an extra histology atlas that he liked. I tried it out a few times, but felt it wasn’t necessary for me. If you are struggling with Histology, you may want to look into getting another atlas, but otherwise the onte textbook is fine.

There are a few supplemental resources for Histo that I thought were worth looking into. Shotgun Histology is a youtube series where a histology professor goes over slides that are pretty representative of what you will see on exams. These videos are short, well narrated, and high-yield.

Histo-Time (Histology Time) is software that allows you to scroll through slides and quiz yourself on different structures. Using it requires downloading a special software and needs some setup. Although I did not use this very much, many of my classmates did. Like anything, some students raved about how great it was, and some (like me) saw that it could be useful but did not really like it. I just felt I didn’t have the time to use it properly. There was a version of this software being passed around during my year, and may be magically placed in your dropbox by an upperclassman if you ask for it. The alternative is to pay the $10 for an entire year’s worth of access. I’ll post the link below.

If your lectures still come from Dr. Jones, then you are all set for boards and the class. Although somewhat long, Dr. Jones covers more immunology than you will ever need, and breaks down the material so well that you will hope for lots of immuno questions on Step 1. We were lucky enough to have him lead the discussion sections, but he may no longer do this. Regardless, watch his videos and take good notes. He is amazing.

I don’t think you should ever buy a separate Immunology textbook or resource unless you are personally interested. My atendings are still amazed that I can remember that IL-5 is associated with Eosinophil activation and asthma. You will be overly prepared in this subject.

OMM

REQUIRED: OMT Review – Savarese

Optional: Foundations of Osteopathic Medicine (Extreme overkill)

There are really three different subjects here: Touro’s OMM lecture, Touro’s OMM Practicals, and Boards-relevant OMM. Each subject requires that you study differently, so let me break it down.

OMM Lecture: I believe that this is still being taught by Dr. Banihashem/Dr. Milani. Most of the lectures are not necessarily board-relevant, but if you are interested in OMM philosophy then you will enjoy them. The faculty does teach the basic concepts of OMT well, and you will have a strong foundation if you put effort into the class. Exams are almost entirely based off of the slides, so go over them several times and you’ll be okay.

OMM Practicals: These were a nightmare when I was taking them. Your grade is approximately 40% how well you memorize the “script”, 40% who your grader is, and 20% divine luck. I did well on these overall, but only because I created a detailed script for every case and memorized exactly what I would say or do for each one. It felt like a performance piece more than anything else. If you get nervous under pressure or speak slowly, these exams will be difficult for you. My recommendation is to practice a ton, and enter with a diagnosis already in mind for each case.

OMM on the boards: There is no real practical for OMM on Step I, and you will be pretty well prepared by the time you finish 2 years of OMM class. All I had to do was go through the Savarese book once or twice the days leading up to Level I and I scored well. Even on Level II the green book is all you need. I never actually used OMM on a single patient during 3rd and 4th year, and put the bare minimal amount of time reviewing or practicing during that time. Two quick passes through the green book and it was one of my highest scoring sections on Level II.

Overall: Use the green book for boards, and the Powerpoint Slides for lecture. Practice and pray for the practicals.

Microbiology

REQUIRED: First Aid for the USMLE Step I (SEE BELOW BEFORE YOU BUY)

Optional: Sketchy Micro

Anki

You’ll get your first taste of Micro at the end of first year, and it can be a lot to handle because you will get hit by pharmacology near this time as well. Both subjects require a large amount of rote memorization. Unfortunately, both Micro and Pharm are very high-yield on Step I, so you need to learn these well the first time. It’s not worth your time to try and cram these, because you will have a hard time during second year trying to re-learn first year material while taking your modules.

When we were taught Micro, the Powerpoint Slides were fairly comprehensive, and did a good job at teaching you the board relevant details. However, I found that using a flashcard style system worked much better for me and allowed me to really retain the information throughout second year and beyond. Most of my classmates used some kind of spaced learning tool to really learn this stuff.

Sketchy Micro.https://www.sketchymedical.com/ was very popular during my year. Basically, the website comes up with a silly picture and a brief narrative that helps you remember all the important details about an organism. You can go over each bug quickly, and the images are memorable. As I said, many of my classmates loved this service. If you’re curious, check out their free images to see if you like it.

Picmonic

You can also use flashcard programs like Firecracker or Anki. Firecracker is a paid service that I used and found helpful. Essentially